T HE SELF-C ARING COMMUNIT Y
The true potential of social prescribing Marion Steiner GP; Self-Care Lead for Bristol, North Somerset and South Gloucestershire Clinical Commissioning Group
A cycle ride through parkland is a good start to my day at work – birdsong, the murmur of water and wisdom of trees. During 30 years as a GP, I’ve learnt what I need to maintain therapeutic energy. Drawing on many sources to broaden knowledge and nourish my consultations, I seek to be an integrative doctor. Over years, treatments and lifestyles have become more sophisticated, life expectancy has lengthened, and the need for perspective, balance and shared decision-making has grown.
A visit to the GP Vulnerable patients with nonmedical needs may feel the safe space of a familiar general practice is the only place to turn to. A range of support stretches from simply signposting someone who is isolated, to options in the community (potentially by reception staff), all the way to in-depth work with a link worker using a holistic asset-based approach tailored to a patient’s individual ideas, needs and resources. Their skill seems to be a key to making sustainable improvements in wellbeing. To succeed SP needs to involve minimum GP referral effort and maximum feedback on outcomes.
© Journal of holistic healthcare
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Mrs Chowdry, an 81-year-old widow, notices the smell of blossom as she walks up the path. She can hear a group of people laughing in the Living Well practice kitchen as they learn how to make cordial from the flowers they’ve picked on their weekly walk, led by a patient volunteer. At the welcome desk, she’s greeted by a health navigator, measures her own blood pressure – nice and low – and sits down to read Poems in the Waiting Room. She looks forward to picking up her quarterly copy, and afterwards sharing it with an elderly neighbour, who she met at Pilates for Pensioners. The waiting room is looking fresh, with a bright new Five Ways to Wellbeing display, and a young mother is using the exercise bike while she waits for her postnatal check, her baby asleep in its pram. Mrs Chowdry is here for a medication review. She had her blood results sent to her mobile phone. It’s been adapted for her arthritic fingers, and she finds it a really useful way to get answers to her questions and communicate with family, friends and her long-term conditions nurse. The text message sent out by the practice about this appointment included some simple questions to help her make the most of her time with her GP. She feels she’s doing pretty well, especially after going to Fun Food for Health classes run by local sixth form
Volume 15 Issue 3 Autumn 2018
science students helped by the community diabetes champion. She was bored with cooking the same things for herself every week, and is glad of new recipes and new friends to try them out on. But she’d like to take fewer tablets and she’s worried about feeling a bit wobbly at times… Dr Simon, her GP, is feeling ready for his first patient. He has cycled to work along the Green City cycle route, avoiding traffic jams and arriving in time for a whole team breakfast, organised by the practice manager who has recently run a mindfulness course. It was Simon’s turn to bring the bread as he’d surprised colleagues by taking up baking: kneading dough, he found, was an excellent way to work off frustrations with the NHS, and much better than kicking the cat. They also shared some of the first raspberries from the community garden, sited on a previously derelict plot of land behind the practice. Simon’s relationship with Mrs Chowdry has evolved over several years. He used to feel his irritable bowel stirring up at the prospect of morning surgery dragging on interminably. Back then he was always glad that she was happy simply to listen to what he had to say, accept her prescription, and leave. As far as he was concerned ‘shared decisionmaking’ was a load of politically correct twaddle, wasting time better spent on improving QOF achievement to maximise practice income.
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